Independent Effects of Tobacco Abstinence and Bupropion on Cognitive Function in Schizophrenia
J Clin Psychiatry 2005;66(9):1184-1190
© Copyright 2017 Physicians Postgraduate Press, Inc.
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Objective: The objective of this study was
to examine the effects of tobacco abstinence and bupropion treatment on cognitive functioning
in adult smokers with schizophrenia in the setting
of a randomized, double-blind, placebo-controlled clinical trial of bupropion for smoking cessation.
Method: Fifty-three adults with
schizophrenia (DSM-IV) took part in a trial of bupropion
for smoking cessation. Subjects were enrolled in
the study from August 1999 to March 2003. Forty-five subjects remained in the trial at week 4;
41 subjects, 19 taking bupropion and 22 taking placebo, completed the baseline and week 4
cognitive assessments and were included in the analysis of adjusted effects of abstinence and
bupropion treatment on cognitive function.
Results: Controlling for bupropion
treatment and baseline performance, 7 days of tobacco
abstinence was associated with slowed motor speed (finger tapping) but was not associated with
worsening of performance on tests of attention (AX Continuous Performance Test [AX-CPT]),
verbal learning and memory (California Verbal
Learning Test [CVLT]), working memory (digit span),
or executive function/inhibition (Stroop) and was not associated with worsening of any
clinical measures. Controlling for abstinence status,
bupropion was associated with reduction (improvement) in reaction time variability on the
AX-CPT and with reduction in perseverative errors on
Conclusion: We conclude that 1 week of
tobacco abstinence is associated with slowed motor speed but is not associated with detectable
worsening in performance on a range of neuropsychological tests or clinical symptoms in the subset
of patients who were able to quit smoking. We also conclude that bupropion treatment may be
associated with improvement in variability of attention.